Tuesday, January 18, 2022

Comments by dogworld

Showing 22 of 22 comments.

  • I agree with you to a point that mental disorder or mental illness are not disability but the way you are going about is a problem.

    Before we abandon professional vs patient paradigm, maybe we need to discuss more and find common ground. “I was one who naively reached out for help several years ago, but fortunately I rejected the “treatment” at the beginning of my exposure to the system. “This experience of yours is quite commendable and may shed some light on what others are trying to tell you. The most glaring question is what did you reject? Be generous we may learn something from you that is quite useful.

    Before we talk about mental disorder and mental illness, perhaps, it would serve the public better or more beneficial, if we agree what is normal? What is health? What are the difference between behaviour arising from normal versus one arising from mental illness and/or mental disorder? What is the difference of completely unable to function versus function at low capacity versus high capacity? Function in this context means: having a job, family, friends, and means to pay for services versus missing one or all of those factors? Why behaviour is not considered? If you are a doctor suffering depression (taking meds/therapy), you are not the same as a person unable to work due to depression – your behaviours of supposedly same condition is extremely different. So, the question is do you really both have depression? What is depression?

    Iatrogenesis means from my experience – if you can heal with words, you can harm with words. If you are arguing against that , please state your position. I think and I could be wrong but your rejection of treatment was probably your own subconscious of realizing the process is biased toward healing and is unconscious of its harm.

    About the pain, suffering etc, rather than putting everything under “mental”, perhaps secondary issues arising from mental disorder versus mental illness may alleviate the confusion. I know reduction is frown upon but there are layers to humanity so which one came first the chicken (depression) or the egg (unable to join the society in any meaningful way).

    Beliefs/perspectives, your example of atheist is straw man’s argument. I will put it this way. As I mentioned above, every single mental condition has extremes: you can have diagnoses for bipolar and be highly functioning person versus bipolar and unable to hold anything. What is the difference between these two situations? If you cannot answer this then the problem is beliefs, culture, subjectivity, objectivity, level of consciousness, experience, maturity, upbringing, and genetics plus infinite factors.

    What is causing the problem is the definition of conditions. Depression makes no sense if one person can work successfully and even in all appearance of purpose has everything while another one is falling through cracks and is struggling with basics of life – getting up in the morning.

  • Psychotherapy is 100% cultural. I came from a country where this does not exist and visited many others where psychotherapy does not exist.

    For example, transference – the biggest tool (mind reading basically by another name) is a common communication style in many countries where the official language of the tribes are oral. In the west, a therapist will tell you what you are projecting, but outside of the room, if you do, you are practicing magical thinking. I wish I was comedian.

    Most mental illness, IMHO, is child’s wisdom thwarted (aside from a trauma related) during development. If anyone actually listens carefully to delusions and hallucinations, they may hear and the may see the real person in there clearly. But it is much easier to label so everybody else knows your inner mind status!

  • Girl let me know tell you something – what you are describing as harm is pure iatrogenic!
    You sound extremely amazing human. Period. Nothing to add.
    I always love your extremely insightful take of this process. I wonder honestly why you are not a therapist yourself?
    Every single thing you write here I had similar experience that I could never put into words as you have. I am very sorry this happened to you.
    That feeling of guilt that is induced in therapy is also what most therapist consider healing – cause it keeps us inline with society! As long as we are feeling guilty of something, we will never do anything against the grain – like leaving therapy cause we are all dependent and professional dependency replaces the mother.
    Feeling guilty, feeling anxious, and full cripple of natural aggression (killing inner power). Well what we end up is absolutely mindless bodies and we stay year after year.
    We will never be alone when we are truly alone – how much gaslighting one can handle?
    Imagine that. If you actually ever record a therapy session and watch it back, you will be shocked the double talk!
    I am thankful for any therapist that gave me space but at the end, I could have lived without re-experiencing childhood trauma in my adult body! Breaking all my defenses and being reduced to baby like state (thank goodness I have a lot of support in my life). The reason people say children are resilient is cause children dissociate/repress and do not remember what happened. When an adult goes through abandonment feeling arising from when they were 1 yrs or 6 months (I wont even guess sexual abuse), ooh mine, that must be just debilitating – especially if the person in the room with you just looks at you!
    I do not know for sure, but I think most people who end up with bipolar label are those who went to therapy and get some serious disintegration going.
    I have been lucky enough to say to my husband almost after each session, ooh boy, I need to break the spell of regression.
    Thank you for sharing your story. You are not alone, and you are just too intelligent to put into words what many of us experienced so succinctly.

  • ““The idea is to offer a sense of justice to a person’s experiences by deeply listening rather than trying to instruct them, give them information, diagnose them, reframe what they say, or discuss ideas: just let them tell their own story, and treat them as the ‘expert’ in what is going on in their lives.”
    Then, from an E-CPR approach, the listener articulates how what the person has just said makes them feel. They do not diagnose or reframe what the person is saying; they simply honor a genuine human connection by sharing their feelings in response to what they hear.”

    This all sounds good but there is a problem. Not everybody is the same.
    There is really no one way to do therapy and to do that is sort of forcing a circle into a square.

    I think it is good to ask the person what they think will help them out.

    There are many people (some of them even write articles on this same site) who are highly intelligent (not acquired but innate intelligence that one is born with), highly educated (sometimes even more than the treating person) and have a lot of high emotionally intelligence (wisdom). So what is the problem?

    Sometimes children are born in the wrong environment which thwarts some development or shuts off the child’s wisdom so sometimes a person wants to learn how you the therapist live, do things/make decisions, and think so they can differentiate from you. Like ooh you do that or I do this and by this mimic, the person learns who they are. All this just talk until you find out who you are is useless – people do this living alone or tic tokc— it does not work. people learn by comparing and contrasting and eventually coming to their own realization – you are a good therapist for giving me space to use you as another mind, but I think I am good with mine and walk away. Adult do not learn like babies so we cannot treat them as such.

    This creates equal power in the relationship and then real healing comes when that power is acknowledged and work with it directly. It is no difference from a good adult relationship with a friend or partner (obviously with some very different areas fundamentally). One being the therapist must be aware of their own internalization and actions more than the client. The client needs a full mind to learn how their mind and body work together something that was missed in development.

    I want to know when I feel this or that what it means for me NOT So much what it means for you – the treater. Most people by the sheer amount of socialization know what others are doing because ultimately we all go to work and school. So what we need help is how to put finger on the mind development by comparing to another mind that hopefully developed healthier than we are to some point. In this way, both people – the interaction is healing for both.

    I want to add the biggest issue in therapy is: we do by identification (maybe for some) and we need to do it by differentiation (cause some need that too) because for the latter, maybe the parent was ill and the child did not want to identify.

    But as long as the concept of therapy is identification and then abandonment – sorry will not work. You will just push people into real trauma bigger than the one they came with.

    My two cents for this Friday.

  • I read that piece and I realized Yager was saying everything psychiatrics cannot do today or it is doing it really poorly. By trying to show what tomorrow may look like, he revealed accidentally how bad shrinks are today!
    The irony!
    ps. let us hope he is writing a horror sci fi book.

  • ” “Doesn’t that create a blurring of boundaries? Don’t clients misunderstand the relationship and think you are their friends, if they know you care about them?” My response is: “Caring for clients is not incompatible with a professional relationship.”

    I have a slightly different approach to this but same nevertheless:

    If a clinician asks this question, ask them back, DO YOU confuse YOUR therapist as a friend or a lover or a stranger or whatever? If they say No! then that is your answer – if you do not confuse why are you assuming (projecting) this to the clients?

    If they say well I do not have therapist or never been to therapy, then the question is you cannot do this job fully if you do not understand the other side. Just go to therapy for a year – if you are confusing their care to something else – stay another year until you are healthier enough to know you are not confusing your therapist to a lover/friend etc.

    Since we are not expecting suicidal clients to have full faculty of their humanity in time of crisis, the next one is also appropriate.

    Radically, if the client with suicidal condition is confusing you to a friend cause you care – that is actually the basis for healing them – since as a clinician YOU ARE NOT confused about the relationship, you can use that as starting place for earning their trust, care, understanding and helping them with their condition at the moment. The problem is the idea that you have suicidal means in this culture, you are one dimensional. You can be suicidal and still lucid to reality.

    Confusing you as a friend can be used as positive – I would say it is better than confusing the clinician as predator!

    Hope this makes sense. English is not first.

  • I want to add my comment above to clarify #3:
    Most of the time (and I met few) people go to therapy with an issue and when they are reduced to this level of childhood driven only by ‘affects’ where the therapist is functioning as the ‘thinking’, many people end up having panic, psychosis or even suicidal thoughts and are considered after ‘difficult’ clients or better to be sophisticated are given real nick names ‘borderline’ ‘bipolar’ or if you really want to erase them from humanity ‘schizophrenia’.
    So often it is frightening ordeal to be driven unfunctional like this.


  • This is extremely timely.

    I am looking at therapy from a person who is from a culture where this does not exist. This is what it looks to me
    1. Psychotherapy seems to be based on Christianity and specifically Catholicism – you go in a room – everything is ‘confidential’ to a point and you speak while a person (whom you do know nothing about) listens.

    2. Psychotherapy seems a way to commodify intimate relationships (no difference than prostitution is commodity of sex not love). Psychotherapy seems intimate no sex (sometime – hence why it is regulated) but intimate one way – very capitalistic. Nothing wrong with this but just let us acknowledge. People stay in it long time cause it is commodity of love without love though – very confusing.
    3. The power difference arises from the client being ‘shrunk” to childhood state of mind versus the therapist demanding they keep gate to what is reality for the child and stay adult state of mind. No winning situation for the client – unless they explode and breakdown and acknowledge this weird situation – and laugh – this is very important to be told you are healed. Or keep your integrity, inner power, leave be bitter for a while and eventually realize you survived a solitary confinement with a weird observational body and actually you have issues but fundamentally fine.
    4. Extreme belief (like again Christianity) that your childhood is more prominent than your adulthood. Is this really true? So if yes, everybody with trauma should be screwed for life. If you are confused about this look above #3.

    5. Do not get me wrong mental health exist but most people who use therapy are quite wealthy so wealthy to be able to pay $100 or more per hour but yet are treated powerless, childlike, encouraged to lead life by feelings (so valid when in fact feelings are so cheap and we have millions of them in life and no one needs to sit on them so long).

    6. Another strong belief like religion – you must talk to a person to heal your childhood trauma but if you live long enough to experience life and heal – not good. Your experience in life is never as good as sitting a room with a person whom you do not know – their word is more valuable than your own experience of a long life! If this was not true, I would have cried. Double-bind – the experience of sitting a room with a person will heal your developmental issues but living life and experiencing real situations to grow through will not. Verbatim from therapist. Not making this up!

    7. Mad in America is antipsychiatry only because you add meds to the above situations, and you basically burn the house down!

    8. I am very sure I will be challenged with there are million empirical studies – yes I smile at this and say sure…but there is also real world out there…just save your money, travel, see how all humanity lives and that is qualia!

    9. You do not need “the father figure of empirical research” keep you in shackles.

    10. Now how did this help me heal. I could write a book about this – very simple but I am running out of time and also want to keep you the same leash as this phenomenon! I am a jokester. The answer is hidden in this comment. Gosh I lived in this culture too long. Love and peace!

  • I think my problem is with the words “peer relapsing”. Why is the peer person losing their agency, autonomy, and personhood to becoming a peer? What is the other relapses for non-peers? Anyone can get sick and take time off so why the peer must be attached to any relapse or becoming sick for whatever reasons. I feel maybe this framing is absurd in the first place. One thing I love about working from home nowadays is that – almost everybody must write emails or be on video and the hall ambushing people in the halls of clinics or offices are not as common. What this colleague did sounds predatory and aggression.
    If the peer gets sick or relapses to whatever they had before IS NOT any different than having vicarious trauma and should not be used as label. If you are acting erratically at work, then your supervisor should send you home if that is what they feel but should have at least another person who also observed without them creating unsafe space where you are being gaslighted. And even if you act erratic and sent home, this should be understandable and not become a punishment unless it is affecting the clients.
    It is hard to discern if you are working in just another toxic place or it was just one incident under the circumstance.
    I am truly sorry you must go through this sort of policing in your workplace.

  • Anecdotally speaking, the problem with schizophrenia is that there are people who have it and are healthy enough to be even psychologist or psychiatrist themselves! Right?

    There are many people with this condition who are living normal lives, so the problem may be that it is not the name or the condition but something else?

    Maybe every psychiatrist needs to have at least one person who had this condition but is healthy now for humbling experience.

    The problem and the stigma is you have this condition and it is a death sentence and you cannot ever get out of it – if you get healthy and move on with your life, and you share this – you lack insight and you are double binded and told you are truly schizophrenic and not know it.

    I do not have solution but as others said maybe differentiating those with positive reactions versus negative reactions may help – so one is evolved spectrum for those functional enough to take care of themselves and the other is regressive spectrum while in the acute symptomology like violence to self or others. And one client can go from one side of spectrum to another or completely get out of the spectrum. The mere fact one person can tell you that you WILL BE THIS WAY FOR THE REST OF YOUR LIFE is seriously flawed especially when many recover with meds or not eventually. We cannot call it a spectrum and yet discount the spectrum.

  • May I propose a radical paradigm:

    There is no loss of openness of the person who is suffering from schizophrenia who is coming to get help. Getting help is an act of openness already. Getting dismissal, diagnosis, undermining of one’s subjectivity and mind is closeness.

    The flip side and where the problem can only be solved is: can the medical industry be open consciously and willing to allow themselves to learn, to listen, to give credence of the person they are treating rather than wanting that person do to what they want “openness” or not.

    I know it is difficult to ask the medical groups to open up to the unknown to become less expert on everybody’s mind…but that is precisely why it is even more challenging to ask a person suffering supposedly from closeness to the masses to do exactly what the medical personnel do not or can’t do themselves.

    The closeness is the system not the individual coming to the system. The major oppressor machine of this extremely difficult condition is language. We use language against them rather than open to them.

    The old quote: If you look at each word, you will see the impersonalization of the experience
    “We propose that schizophrenic experience might be understood as arising from a dialectic relation between the self’s loss of openness to the world and the world’s loss of openness to the self.”

    Now let me re-phrase this:
    We propose that a person with schizophrenic experience might be understood as arising from a dialectic relation between the system’s/culture/etc loss of openness to the world and the world’s loss of openness to the individual with schizophrenic experience.

    Let us try that now using some imagination.

  • IMHO, what I learned in therapy is that it is easy to focus what went wrong and how wrong are you still than what went right and let us focus what actually make you get here in the first place – most people are so focused what is missing and wrong than their inner wisdom. Therapy does not focus making that inner wisdom conscious but pushing more about the trauma or diagnosis (same thing really just different flavour of socially engineered way).
    If we use language appropriately in therapy, we would be talking about not how you got traumatized by your father abusing you (which let us be honest no one can recall at certain age) but more about what have you done right since, how did you become you, tell me your human secrets and by telling that, one sees themselves in different light. Imagination is a tool so under-rated. What makes a child happy and free is imagination that dies in therapy rooms of adults.

    We do not do that because doing that requires, we let go of power, authority, and taking function (taking over the clients’ observing mind) and using silence to literally induce solitary confident of the mind while sadly with another who is so boundaried of their mind – it is like if you are so afraid of losing your mind as a professional, then you must understand you can also steal others’ mind and create a void…which is how trauma is created – stealing one’s mind not brain…the mind.

    How can you be in therapy and talk about trauma without ever mentioning the word wisdom or imagination? Trauma kills the child’s free spirit and imagination. Therapy, if done right, should focus on unleashing the imagination and the free spirit not swim back in the cesspool of what happened that most people cannot recall in language!

  • Pointing out his blackness is sort of the problem. It is OK MIA has “black contacts” and gives a forum…again what is the problem?

    I think what this man’s story shows is the fundamental striving for humanity. He can show his shortcomings and those powers above and beyond that just were barrier. I could not empathize every decision he made in the past but I could see his struggles. At the end, I was on cheering at his delight in being independent in his 60s with all these health issues and giving his universal given wisdom whatever it might be.

  • I am with @l_e_cox on this one to some extent.

    A beautiful mind writes this piece. A beautiful mind without a body. The body is there but the mind that is so beautiful to put this piece together has no attachment to the body. So the body seems really pissed off, hence, the mind in order not to harm the body, created the distraction of the meds. So all feelings are toward the meds because it is much easier than making peace with the body – the corporeal always demands and wins. The meds are metaphorical entity for the feelings toward the body. I feel this because you mentioned your age – that is the age of the body and its weight of all the decisions made on the body – the body wants freedom to connect with the mind so it can go places that solid things cant (that might be a way to avoid mania) but a fight against mania is fight against imagination and against freedom itself!

    You have extremely strong and resilient body to carry on regardless.

    The mind is still youthful, growing, expressing, and searching for freedom but in order to get there, minds need a body as vehicle!

    Freedom in the body without mind is addiction. Freedom in the mind without body is harmful/psychoticism. Using imagination/creativity without database is to engineer bringing both together. You entice me this way in my own recovery.

    Where I differ from @l_e_cox is that the mind is also in the environment like oxygen is but there is/are unknown parts – we do not have words yet that know the mind and the body – what is looking and talking about the mind is not the mind or even consciousness to me this is the end of language – maybe a music or piece of art can show but no articulation. That is a slight variation I have.

  • Fascinating stuff!

    I was blown over by “commodified suffering” comment. I have been calling this as the commodified feelings. In the mental health system, the most commodified feeling or state of mind is empathy. Try to show empathy, and it is taken right off your mouth, and you are forced into regression, and only then, you will be released until you again show the same empathy that was not allowed from you earlier. Do not worry of others (killing any collectivism on the way), just worry about your feelings as first person (creating isolation of the mind). Of course the therapist must show empathy, must function as my own empathy since I am not allowed because I am a child…symbolically speaking but yet as if. writing this down is making me go mental already. No reason to make helping others so categorized…it is soft, it is malleable, it is flexible, it is human connection of the mind, the body and the others all at once, all apart organically, and all mixed when needed in so many different capacities. No hard rules!

    As a helper myself, I decided, there has to be a way to heal without functioning as their empathy (by rendering my clients disable). I want them to keep their empathy and still heal. I empower them to keep their empathy and heal with it with me or with them alone.

    but the commodifying empathy, keeps the client keep coming back year after year…depleted of all humanity!

    Thank you for putting words things I notice in healing business in therapy that did not make sense.

  • @Daiphanous Weeping
    Sometimes your comments remind me of my experience in therapy. I feel that may not be your intention cause you have no idea but what you write often touches me.

    I had a very violent childhood trauma that went on until I left my family of origin at 19. I have enough scars to cause me infertility. But, the big but is that I lead a decent life where I have never been on meds, or hospitalized or went to jail (well let us not count shoplifting as a teenager and early young adulthood) but I have grown up and only saw my childhood – the worst experience of my life- and now that I am out of it – I need to catch up living to the fullest! so I live in momentum of life!

    Then I wanted to become a therapist…and felt I need to see if therapy works first. No matter how good my life is or I say I am happy, the invalidation is I am traumatic person and must have PTSD….PTSD is the best code in health cause there is no cure! but I have no symptoms to reduce but I have yes really violent experience that I never sought help with a professional but I have so many siblings, relatives, I love my friends, my husband…I am well taken care of. None of those are good if I did not process it. Even though I am not short of processing anything. There is nothing to process if the experience is in my language anytime I need to speak of it.

    Processing a trauma is cultural. Something one does cause there is no any other way of healing. Well I grew up a different culture where processing is part of life!

    But I am not on meds never been. I am not interested in reducing symptoms, do not have any. I have support. I have a great job. I am happy and sad as normal human. But in the system, I am reduced, shrank, to my traumatic childhood. If my parents abused me while loving me, the system is validating me unless I agree with them.

    I want to become a therapist that just believes what the person wants not what they want while they are with me…I do not want to be the centre of their language target. I want to be an observer and my impact is up for interpretation and disagreement not for compliance and identification.

    My shield was dissociation (severe enough but did not even know it so not scary enough but not in split personality level) BUT I still manage to own few properties in one of the most expensive cities in the world, married truly happily, helping others who may have less than me in material…and see the world. What more do I need that I would have if I did not have bad childhood and suffer dissociation that I only learned during therapy.
    I am not allowed to say yes my childhood was bad but I not traumatized by it in a way that I must identify with it. and I cannot truly say my bad childhood screw me over forever cause I would be lying.

    What I am trying to say is I really understand you have an illness or you do not – and that does not mean anything material in your life. but in order to speak with others, we must use language and to make easier for them to understand, we must identify with something but I do understand your refusal to do what others need in the conversation. But I also understand you or anyone needs to appease others in language. Your experience should be able to stand alone without me or anyone else getting satisfaction of relating. It is OK not to feel relatable sometimes or forever. It is hard to hold two conflicting and contrary thoughts at once.

    I asked often what more would I have if I had perfect childhood? Nothing would have changed. Sure maybe I would be faster in thinking, would be able to have a child cause I am not bruised but…then there are millions like me so I am not alone. Regardless, I just wanted to say I hear you and even my hearing does not mean it is important.

    I am speaking for me when I said, I love your extreme ability to hold so many contradicting thoughts and still express them in language. Not an easy feat.

  • I think and I am sorry if I am not fully knowledgeable about the framework of working as Peer Support, what does “equal” mean in a context where the two people are not equally relating?

    IMHO, I am a wounded healer (well that is a bit too much). I am a person who experienced a violent and systematic abuse for long period of my life and recovered enough to lead satisfying life including in training to become a therapist myself. I have experienced power imbalance during my recovery in therapy process not so much hospital (which power imbalance is more prevalent). What I learned from my personal experience is that power and authority are mainly perception issues (unless a physical material is involved where one is being held)…but in mental health power and authority are perception.
    I never had that perception (or more likely) I have had it intellectually but understood it enough not to act on it and also not to endow on any therapist that helped me along the way that my vulnerability is equal to less power of my autonomy.

    Now the word “equal” is problem. Because a person is seeking help and one is giving help in terms of “empathy” and “support”. That mere giving has a power to stop giving…but also the taker has a power to refuse taking…so that power and authority are shared BUT ONLY if both are verbally, consistently, remaindering each other in almost every step of the way consistently and purposefully.

    Equal power and authority only exist if it is verbalized often and both are allowed to say what they think about it.

    I think peer support to believe they are “equal” while working and have obligation to a system, organization or other authority is not really equal anymore and forget if there is even payment involved. We are just stretching the surface and creating a real doublebind here.

    I hope I am not coming off as semantic expert (I am far from that) but I think the equality of the peer support and a patient/client can only be real if both actually speak of it as negotiation in such that the client/patient can say something like (and allowed to say)…I do not want that code in billing (and the question is truly why a peer support is even involved in coding)….all the roles seem to be mixing.

    A peer support framework does not seem clear.

    Another issue that bothers me about the process for peer support is the loss of identity as you mentioned. Not only identity, but autonomy and ownership of their experience (one experience must determine their profession) and also if they get sick – they are not given the same flexibility…all of sudden the question is what? I thought they recovered? they are “shrink” to that experience forever! Having a peer support should be a generic like being a psychiatrist and having MD in your name…a peer support should not be reduced to their “emotional challenge” actually IMHO< that should not be even a requirement…cause all humans have challenges in emotions – divorce, job loss, grief, loss, sickness etc….peer support should be based being human who wants to support anther human without being a clinician. Otherwise, the peer support cause you have been hospitalized reduces the person' human value to the contribution of humanity!

    The peer support needs to create their own framework without the system that created their need. They need to flush out all the possible scenarios including minimizing their own recovery experience to a template but not the foreground cause we are all different humans and our experiences are not alike ever! maybe to a point but not to duplication. To me this sounds a little boy who wants to be like his father but will never be because the father is created in different world so forever striving to be like the father is useless…what the little boy needs to do is become his own man. (use of gender is to make a point easier).
    Now the peer support needs a system that is not modeled in the system that created but based on their own coming to a new paradigm of what is mental health. But that will also require some quality control for huma interaction and if there is a confusion of service…a peer support must be protected as much as the person they are supporting. Any time two humans meet, there will be some misunderstanding so that needs to be addressed as well – I never see this being addressed. Safety, protection, privacy, ownership of experience are all things that need to be worked through outside of the known system to start afresh!

    ps. I am operating from non-believe of power in mental health, diagnosing of human emotion and making some emotions into monsters and others to friends and also from the point view of peer support is more than just those who had experienced the system but those who also learned how to become independent in their mind from the system enough to work to through it but who are still humans and may have remissions but do not need to perform to show others how much they have come or be validated for their experience (I know mouthful)….but peer support need their own framework outside of the system. The system should come to them not the other way around.

  • This is a great article and touches so many layers of what it means to have mental health issues, poverty, and heal and integrate oneself.
    First, only in the first world do people truly correlate mental health with poverty. There are a lot of poor people who do not have mental health issues.
    Mental health is one of the most equalizer in humans. Anyone can get it but some people have the means to recover or the resources. Having resource is not a prevention of mental health, it is treatment of mental health.
    The need for the individual to have all they need inside (mind, imagination, creativity, esteem) is just as important as the need to have others in their lives for things like love, relationships, friendships, support, humor, creativity, sharing…
    So the problem often arises, when the two are split hard by culture, politics, or some kind of mental processing that may not be obvious to the person involved or genetically inherited genes of such. I often make the comment if you are so individualized, one should live in the mountains alone forever! and if you want to give up individualism and live fully collectively, then just join a cult! (being sarcastic cause I am very sure both are doable in some sensible ways…)

    So this article is touching a lot of layers that most of us want to keep balanced but it is hard.

  • As someone whose culture does not have psychotherapy like approach to mental health because the culture is collective and people who are struggling with basic mental conditions depression, anxiety schizophrenia etc. usually are taken care of family (which creates its own problems obviously), I would like to weigh in this topic from that perspective.

    First and foremost, if something can heal it can also harm. Arguing about that is useless. Anytime you have two people in a room for extended period of time, and add a mix of one person having strong boundary of the mind, while the other is expected to empty the mind so both can look at the mind together, is recipe for healing exponentially and also has just as much risk of exponential harm.

    That differential of the mind access is something, as psychotherapist we are not fully allowed to discuss in a deeply and meaningful way because most training truly believe one can boundary the mind that hard and that long in this process. Just as much as clients are emptying their mind with their consent so they can see their own inner workings and intricacies, the psychotherapist is also subtly emptying their mind but not open for the client to comment on it.

    When I went to therapy to become a therapist, I had no idea how therapy works. I mean that exactly what it means. I knew I will sit in a room with a person but I had no idea that I would be expected to give a ‘consent’ to empty my mind so I could see it with another person. I did not have the concept. I did not grow up in the concept. I wanted to help others and wanted to learn the techniques and I was educated myself in therapy!

    I broke down completely due to my own unprocessed childhood trauma that was not oblivious to me but I managed decent life so I never dwell on it. But sitting a room with a person whose mind was boundaried on purpose (just like my mother, whose mind was boundaried unconsciously when I was born), I fell unceremoniously into complete black hole full of extreme regression and dissociative states I did not know I carried. Because prior I did not have any mood or panic or as far as I know organic underlying, I had to anchor myself with my own adulthood memory of I was functional before therapy and now all of sudden I am broken down what is going on????

    I decided to learn the process more and break it down.
    First the consent to the mind and the inner workings of the client is not understood universally or even culturally. When we are asking consent to treatment, IMHO, what we are asking subtly (this needs to be spelled out) is that I, the therapist, will like to have access to your inner mind, inner dialogue, and I promise to treat that with upmost respect and empathy and whenever I fail as I will as human, I will hope we can work out with your functioning, integrated side. Can you give that consent? Very few people will do until they trust the person and the conversation is very clear not ambiguity.

    The harm is this: sign consent – full of words without meaning. Start talking and empty your dissociative, disavowed parts to a person you may trust or not- immaterial. The therapist gets access and does not share the information with the functioning parts of the person that gave the consent. Language is used in obfuscation.
    In severe states of dissociative or extreme regression, symbolization, meaning and sophistication are harmful – no different than if you are talking to a toddler about death! The therapist must learn and ask spelled out consent each step of the way until the client’s integration parts are more on the foreground more often than the dissociate states and can digest, metastasized and symbolized the meaning of the things found under regression.

    Now the therapy started with the blank state just like the first heart surgeon probably butchered a person to learn but as surgery has become more sophisticated, therapy has become more confiscation.
    A therapist that can articulate their inner workings with the client from the client who is paying a very high price and who is working, functioning, striving for health in every day…is the right therapy. A therapist with the mentality of I see your inner workings are so broken, and I am going to function for you without your consent is harmful without even knowing.
    Only a highly integrated, functional person can give a full consent to empty the mind at will with another who is not doing the same. A client who is emptying the mind automatically to the therapist, it is the therapist job to name this and make sure there is a consent.

    There is a great article by Wolfgang Wöller et al that basically states: for complex PTSD, the therapist should not engage directly, collect information, build a relationship with parts that are showing up in therapy without the functional adult paying side of the client ….there is no consent to treat until the person paying is on it. Most therapists are so eager, excited to access others’ mind that they forget there is a person who owns that mind sitting Infront of them and without that part (the most autonomous and important part that came to therapy in the first place) must be respected, empathic and taught how to take care of the new parts — the functionality of therapists must be clearly stated until the client is almost integrated enough to give full access for the therapist to be functional in much greater ways. Basically Woller is saying, only those very integrated can allow the therapist to have access to their inner mind. Make no assumption and ensure as therapist if you are having conversation with parts of the client that the client is not aware of, stop, get a consent from the functional part of the client.

    This my take…maybe too wordy but this is very complex intersubjective experience and going high in the power imbalance or not being aware of it and what it means, causes a lot of the reasons the therapeutic does not work.
    The more severe a person is, the less symbolization and more direct, IMHO. And as the person heals, integrates and learns how to carry their own small, primitive childlike parts (their vulnerability), the more they can withstand another person accessing their mind.
    The focus on technique is kind of barbaric. Think this way: can we teach mothers how to be even just good enough mothers? No….we cannt because there is no human technique.
    It all boils down to asking consent every step of the way to access another’s mind and have conversation about that and allow the client to witness their own breakdown without fear, mystery and confusion…the more they heal, the more they will allow the mystery, the symbolization, the meaning making…but not while they are processing infantile or epigenetic materials that were highly traumatic.

    I hope this makes sense but I thought I will share my experience of therapy for the first time and going get out of my mind – you devil, I need to solve this person accessing my mind and resist, to is this person helping me, to ooh this person is trying to help me and support me but they should ask my permission first? and I realized I had no idea what therapy is truly.

    Just coming to therapy alone is not a consent to poke around other’s mind.

  • Before I went to therapy in my 40s for childhood abuse, I volunteered for almost 30 yrs so by the time I arrived for therapy, I was already mostly integrated because all those I helped along the way, inadvertently also gave me parts of themselves for me to heal! I found myself in therapy comparing the exact implicit memory to a real memory from my volunteer about how I learned who I am truly!
    Empathy, Altruistic, and Connection are three words I would use to explain my volunteer background.

    thank you for putting it so beautifully.

  • “Moving on, you have defined madness as ‘the moment in a conversation that one of the interlocutors decides to halt the interaction, legitimizing this by adducing that communication would no longer be possible and motivating this by calling the other “psychotic,”’ which I thought was brilliantly astute. In light of the above, does it also make sense to think of such diagnostic interactions as rooted in a sort of ‘confusion of tongues’ between residents of different worlds? ”

    This sounded to me when the therapists over value the interaction or the relational aspect of therapy over the self, the species person/the animal/the organism, the autonomy and if these two are separated by virtue of one’s past trauma, one becomes the disposal of the other to be called – psychotic rather than let us see where we are at. Psychosis may be defined when two people speak to each other and one does not understand the other and has a power over the other, then that one names the other as psychosis rather than wondering, becoming curious, and try to learn what is this person is saying.